RELATIONSHIP BETWEEN THE BONY AND MUCOSAL WIDTHS OF OSTEOMEATAL COMPLEX SPACES/DISTANCES AND THE SEVERITY OF CHRONIC SINUSITIS - A CT STUDY
1Kırıkkale Üniversitesi Tıp Fakültesi, Radyoloji, Kırıkkale, Türkiye2Kırıkkale Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları, Kırıkkale, Türkiye Purpose: To investigate the correlation between the severity of the maxillary, anterior ethmoid and frontal sinusitis and the bony and mucosal widths of ethmoid infindibulum and uncinate process-middle concha spaces and the distance between lamina papyricea and middle concha.
Materials and Methods: On paranasal computed tomography images of 49 patients with chronic sinusitis, the distances between bony and mucosal contours of ethmoid infindibulum and uncinate process-middle concha spaces, and between bony contours of lamina papyricea and middle concha were measured from 98 nasal sides. Inflammatory pathologies were groupped according to the decrease of the related sinus ventilation, as none, mild (less than 1/3), moderate (1/3 to 2/3) and severe (more than 2/3). Anatomic variations such as septal deviation, ethmoid bulla overpneumatisation, bulbar concha bullosa, uncinate process aeration and deviation, haller cells were recorded.
Results: In cases with severe maxillary and etmoid sinusitis, the mucosal infindibulum and bony infindibulum distances and in cases with moderate-severe frontal sinusitis the mucosal infindibulum distance, were noted to be narrow than the cases with normal sinuses (p<0.05) There was a significant negative correlation between the bony infindibulum distance and the severity of maxillary sinusitis, between the mucosal infindibulum distance and the severity of frontal, maxillary and ethmoid sinusitis and between the mucosal distance of uncinate process-middle concha and the severity of frontal sinusitis (p<0.05). We noted at least one or more anatomic variations in 35 (71.4%) cases. Lamina papyricea-middle concha and mucosal infindibulum were narrow in cases with anatomic variations.
Conclusion: Besides the mucosal changes of osteomeatal complex, the decrease between the distances of bony structures may also play a role in the ethiopathogenesis of the inflammatory sinus pathologies. The constriction of the bony infindibulum space seems to be an important factor for the development and progression of the maxillary sinusitis.
Keywords : Sinusitis, osteomeatal complex, anatomic variation, ethmoid infindibulum, uncinate process, computed tomography